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beTherapy Enteropeptidase: a novel targets for obesity & type II diabetes treatment http://www.obetherapy.com Strategy for obesity drug development -CNS (appetite, satiety) -Increasing energy expenditure -Peripheral target 2 Targets for obesity treatment past and present in R&D Appetite NPY Orexin PTP-1B AGRP MG CNTF DPP IV CB1 (rimonabant) Satiety OB DB CCK POMC MCHR1 Tubby CART gherlin FAT GLP-1 MC4R PYY (3-36) 5-HT receptors Serotonin (Meridia) Energy thermogenesis Fat and Carb. metabolisms UCP1 PPAR-γ UCP2 SREBP1 UCP3 C/EBPs PKA-IIb β-Adrenergic R α-Adrenergic R ACC-2 Others SIRT1 H1 receptors FATPs PRMD16 BMP-7 SGLT1 PL (xenical) SGLT2 MTP Adiponectin PTP1B PTP1B Glucokinase Histamin S6K1 3 Molecules withdrawn from Market due to major side effects: - Thyroid hormone withdrawn 1920 increasing metabolism - Dinitrophenol (DNP) withdrawn 1930 UCP - Dexfenfluramine (Redux) (amphetamine) withdrawn at early 1990 - Fen-phen and dexfenfluramine withdrawn from the market in September 1997 - Ephedra was removed from the US market in 2004 over concerns that it raises blood pressure and could lead to strokes and death - Rimonabant (Acomplia) It is cannabinoid (CB1) receptor antagonist that acts centrally on the brain thus decreasing appetite, withdrawn 2008 -Meridia (reductil): Abbott withdraw its obesity drug from the U.S. 2010 -Mediator Servier lab. withdrawn between 2004-2012 in all EU countries. ObeTherapy approach Consist of looking for a genotype associated with inefficiency in energy absorption. Can be found in rare individuals with a “lean phenotype” or “starvation phenotype”. «non variable phenotype» Congenital Enteropeptidase deficiency “starvation phenotype”. Cascade of Biochemical events starting with proenteropeptidase Proteins Proenteropeptidase Enteropeptidase Pepsin Trypsinogen Trypsin Large peptides Chymotrypsinogen Chymotrypsin Proelastase Elastase Procarboxypeptidases A and B Pancreatic prolipase Carboxypeptidases A and B Pancreatic lipase Small peptides Aminopeptidases Dipeptidases Tripeptidases Free Amino acids + Triglycerides Congenital enteropeptidase deficiency starvation Phenotype The pancreas produces proteases, protein-digesting enzymes that are activated once they enter the duodenum Pancreas Membrane-bound enteropeptidase Inactive trypsinogen Other inactive proteases Figure 41.20 Trypsin Active proteases Lumen of duodenum 14 Addition of amino acids to the diet overcomes the problem of growth retardation. Polonovsky Et al 1970 Arch. Franç. Péd. All patients respond favorably to Addition of Pancreatic enzymes. Gastroenterology. 1983 Sep;85(3):727-31. An Esp Pediatr. 1978 Mar;11(3):219-26. Arch Dis Child. 1975 Apr;50(4):277-82. Enteropeptidase specificities Trypsinogen sequence recognized by enteropeptidase Nt-…..-Asp-Asp-Asp-Asp-Lys-Ile-Val-Gly-Gly-….-Ct Human enteropeptidase model of the catalytic domain (made by MEDIT) Virtual screening and docking with potential compounds 11 Rational Drug Design for Enteropeptidase Serine protease Common fold (catalytic domain) Specific subsites Crystallographic data (bovine origin) Catalytic mechanism 17 Possible sequences of enteropeptidase inhibitors Structure-function relationship of human enteropeptidase (Biochemistry (Moscow), 2006, 71(2), 113-119). Ala-Phe-Arg-Boronic Ala-Phe-Lys-Boronic 13 Acute Effect of OBE lead on Triglycerides absorption n=3 each group Acute experiment with C14 radioactivity n=3 each group 15 Effect of OBE lead on weight DIO of treated mice n=10 each group 19 Effect of OBE lead on food intake of mice n=10 Pharmacokinetic of OBE lead compound in mouse Area (relative units) iv, PO route normalized to 1mg/kg Time (hour) IV route: OBE lead compound rapidly distributed and eliminated to an undetectable level with an half-life of 21 minutes PO route: Negligible absorption with a calculated biovaliability 2-3%. Ex vitro (in plasma), degradation of OBE lead compound was extremely rapid, generating two major metabolites under limit of quantification after 2 hours. Those two metabolites were not detectable in vivo. Measurements were done with LC/MS/MS In conclusion Due to negligible absorption; fast elimination and rapid degradation in plasma, systemic exposition to OBE lead compound is negligible after oral absorption. Advantage of Enteropeptidase Target: • Peripheral target (intestine), therefore less side effect as compared to a systemic target. • No absorption (PK study), no side effect. • Linked to lean «starvation» phenotype in humans • Tissue specific • Non redundant 22 Scientific Advisory Board Prof. M. Radman, Hôpital Necker, Paris, France; "Académie des Sciences de l'Institut de France". Prof. A. Levy, The Weizmann Institute of Science, Rehovot, Israel Prof. T. Baasov, Chemistry Faculty Technion, Haifa, Israel; Prof. B. Peault, Institute for Regenerative Medicine, UCLA, USA; specialist in cellular models and biotechnology, pioneer of Systemix. Dr Y. Champey, former Senior Vice President and Executive Medical Director at Rhône-Poulenc Rorer. Prof. D. Bensimon, Ecole Normale Supérieure, Paris, France Prof. M. Rubinstein, Weizmann Institute, Israel; Prof. D. Ricquier, PhD, Director of CEREMOD/CNRS Unit 9078, Hôpital Necker-Enfants Malades, France, member of the "Académie des Sciences de l'Institut de France". Prof. N. Stern Director, Institute of Endocrinology, Metabolism and Hypertension, Tel AvivSourasky Medical Center, Israel. Arieh Warshal (Nobel prize laureate 2013 in chemistry),University of Southern California US 17 Publications: - Jolivet, G, Braud, B., DaSilva, B. Gautier, T. , Lagrost, L., Houdebine, L-M., Harosh I* (2014) Validation of APOBEC1 as a new target for obesity treatment using RNAi transgenesis strategy published 12 Sep 2014 | PLOS ONE 10.1371/ journal.pone.0106655 - Harosh, I (2014) Rare Genetic Diseases with Human Lean and/or Starvation Phenotypes Open New Avenues for the treatment of Obesity and Type II Diabetes (submitted: Current Pharmaceutical Biotechnology). - Braud S., Ciufolini M., Harosh I* (2012), Enteropeptidase: A Gene Associated with Starvation Human phenotype a Novel Target for Obesity Treatment. PLOS ONE 7(11): e49612. doi:10.1371/journal.pone.0049612. - Braud S., Ciufolini M., Harosh I*. (2010), Energy expenditure genes or energy absorption genes: a new target for the treatment of obesity and type II diabetes, Future Medicinal Chemistry Volume 2, Number 12, December 2010 , pp. 1777-1783(7). - Harosh I, Braud S and Ciufolini: (2010) Boropeptide inhibitors of enteropeptidase and their uses in treatment of obesity, overweight and/or diseases associated with an abnormal fat metabolism. US Patent Application No: 2010/0311,690. Lean genes allow you to eat without gaining weight... Nature did it, ObeTherapy can reproduce it.